This article includes discussion of structural, functional, and neurochemical imaging of movement disorders.

Overview

Historically, imaging studies were used experimentally to expand our knowledge and understanding of the pathophysiology and genesis of movement disorders. More recently, a few of these imaging tools have become part of clinical practice. In this article, we will address some of the key finding across imaging modalities in Parkinson disease, essential tremor, Huntington disease, dystonia, and Tourette syndrome.

Key points

• Structural and functional imaging studies are increasing our understanding of the underlying pathophysiology of movement disorders and beginning to show some utility in their ability to aid diagnosis and inform treatment development.

• Neurochemical imaging can be used to visualize nigrostriatal dopaminergic denervation in Parkinson disease and may allow for early diagnosis and monitoring of disease progression, whereas the structural and functional changes in Parkinson disease may enable the ability to differentiate between motor and cognitive subtypes and to distinguish the disease from atypical parkinsonian syndromes.

• Advanced imaging techniques can be used to characterize the altered structure and aberrant function present within tremor-related cerebellar pathways in essential tremor and may help elucidate the presence of different phenotypes of this common movement disorder.

• A variety of imaging modalities have shown promise in detection of structural, functional, and neurochemical changes in pre-manifest Huntington disease and could support the development of disease-modifying therapies for this devastating neurologic disease.

• Although application of a broad range of imaging approaches is expanding our knowledge of the structural and functional changes associated with dystonia, additional larger and better controlled studies are needed to unravel the complex physiology leading to this disabling disorder.

• Signaling pathway changes and the disruptions in motor, limbic, and cognitive circuit function that underlie the tics and other neuropsychiatric symptoms of Tourette syndrome may be able to be elucidated using modern neuroimaging techniques.

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